Myocardial Contusion: Likelihood Ratios

Introduction: Myocardial contusions are injuries to the heart muscle from blunt trauma to the chest. Principal complications are arrhythmias and ventricular (especially RV) dysfunction.

In a large case series (PMID: 2363607), blunt trauma patients who survived to admission and were suspected of having myocardial contusion were unlikely to have arrythmias (only 4 of 95 patients developed arrhythmias necessitating treatment), and none developed new heart failure. No patients admitted to unmonitored beds had arrhythmia or new heart failure. In this series, cardiac enzymes were frequently elevated but did not predict morbidity.

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Prevalence

The likelihood ratios of findings for Myocardial Contusion are listed below. See the left navigation bar to change the display.

Good Positive Likelihood Ratio

Finding	+LR	-LR	Comments, Study
Troponin T	inf	0.9	contusion by echo / ECG criteria - may reflect overdiagnosis Study: Emerg Med J. 2002 Jan;19(1):8-10. PMID: 11777862
Troponin I	7.7	0.8	contusion defined by echo / ECG criteria only - may reflect overdiagnosis Study: Emerg Med J. 2002 Jan;19(1):8-10. PMID: 11777862

Findings With Unspecified Accuracy

Finding	+LR	-LR	Comments, Study
ECG	No accuracy specified.		In one series, ECG abnormalities were found in 70% of severe blunt trauma patients but did not correlate with mortality. Study: Emerg Med J. 2002 Jan;19(1):8-10. PMID: 11777862